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DoctorTro

@DoctorTro

Apr 13

🔔 Where did Ozempic & Monjauro come from? 🤔

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🦎 The Gila monster (Heloderma suspectum), a unique lizard known for its binge-eating behavior, produces the hormone exenatide, the basis for diabetes medications such as Ozempic and Mounjaro.

This reptile stores significant amounts of energy in its fatty, moisture-rich tail, aiding in weight and hydration maintenance. The GLP-1 hormone is exclusively released from its saliva through the act of chewing. When liquified food is injected directly into its stomach, the hormone is not released, highlighting the importance of chewing in this process. GLP-1 is thought to signal satiety and help regulate blood glucose levels during digestion. The Gila monster consumes large quantities of food relative to its body weight, often ingesting whole rodents and digesting them over 1-2 months.

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DoctorTro

@DoctorTro

Mar 30

When I entered medicine, it was deeply personal. My family’s struggles with obesity and metabolic disease were my driving force. I watched my brothers reach 400 to 500 pounds, and our family was plagued by diabetes, hypertension, and more. I thought becoming a doctor would give me the tools to help, but what I found was a system that often prioritized profit over patient outcomes.

In the early 2010s, I began noticing issues with the CMS reimbursement structure. The payment model seemed designed to incentivize procedures and chronic disease management rather than prevention. Spending time with patients to address root causes wasn’t valued. Instead, quick fixes like medications were prioritized.

My skepticism grew as I delved into public health issues. Water fluoridation, for example, was accepted without question. Yet, when I examined the data, I found no significant difference in dental outcomes between fluoridated and non-fluoridated countries. This revelation made me question other unquestioned practices, like the push for flu shots without considering individualized risk-benefit analyses.

I marveled at people like @gorskon who claimed that herd immunity was an efficacious endpoint for mandatory mass flu shots… for a product with 10-60% match rate 🤔

To make this simple, it’s the equivalent of making the false claim that we can keep out mosquitoes with a chain link fence.

These people were liars, plain and simple and now post COVID we know this even better than ever.

Just look at the exaggerated claims we had to endure.

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DoctorTro

@DoctorTro

Mar 14

If you want to tackle your weight or diet-related disease, you need to pick a side.

Let’s talk about food addiction!

🧵 /thread

2 paths, you much choose one:

One path: Acknowledge that your identity is shifting and that your relationship with food needs to change. If you recognize that certain foods are addictive and damaging, then commit—either abstain or harm-reduce with intention. If this is your path, you must fully own it.

The other path: Accept that you are choosing food as a psychoactive substance and a source of pleasure. Own it. Radically accept this choice without guilt or shame, and stop punishing yourself for it. If you take this path, fully embrace it—savor every bite, eat slowly, actually taste your food, and enjoy it. If this is your choice, then let it be a true choice, free of internal conflict.

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DoctorTro

@DoctorTro

Feb 14

🚨 NEW PAPER 🚨

Making America Healthy and reversing obesity, without drugs & injections

By focusing only on metabolic health, patients lost 15.5% of their weight while STOPPING unnecessary medications

👇🏻👇🏻

50 patients
⬇️43lbs on average ‼️
💥~15.5% weight loss at one year💥
🤔 Majority of patients KEPT losing weight even after stopping GLP1
🤔 Even at 1 year, 76% of patients were STILL losing weight - BUSTING THE MYTH that “patients can’t adhere to diets longterm”

I’ll walk you through why some of this is REALLY important

This paper looks at the 1 year weight loss results from our virtual metabolic health program with CGMs, smart equipment, an app and virtual coaches.

Paper linked:
frontiersin.org/journals/nutri…

Please RT, bookmark & share this link 🔗 to spread awareness so doctors know the power of metabolic health and lifestyle changes NOT only pushing medications 💊

🧵/THREAD

🤌Allow me to set the stage.

The current accepted truths in medicine is that GLP1 meds have unprecedented results and there is no other options because “all diets fail”

But have medical teams actually tried to help patients adhere ? 🤔

They haven’t. Why? Because it’s easier to prescribe injection weight loss drugs than to promote & inspire lifestyle change

But the sad reality is many patients cannot tolerate the injection drugs due to side effects while many others don’t actually need it.

If every patient with obesity and diabetes goes on these injection drugs corporate America and Medicare will go bankrupt from the trillion dollar burden it would cost.

So our clinic aimed for better.

A completely new care model called TOWARD

And how did we do?

We created a multi-modal approach to metabolic health leveraging telemedicine, convenience and real-time access to doctors and coaches who actually care because they have lived it!

We created a unique app
We leveraged smart scales, CGMs and remotely monitored blood pressure cuffs to help predict weight loss and intervene in real-time before weight regain occurred

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DoctorTro

@DoctorTro

Feb 4

🚨 THREAD 🚨

GALLSTONES & GALLBLADDER DISEASE

Everything you need to know about gallstones as it relates to diet and dietary composition.

👇🏻👇🏻👇🏻👇🏻👇🏻

In the obese during rapid weight loss from a very low-calorie diet, a relatively high fat intake could prevent gallstone formation, probably by maintaining an adequate gallbladder emptying, which could counterbalance lithogenic mechanisms

nature.com/articles/08006…

On the basis of a meta-analysis of randomized controlled trials, during weight loss, UDCA and/or higher dietary fat content appear to prevent the formation of gallstones.

sciencedirect.com/science/articl…

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DoctorTro

@DoctorTro

Jan 25

🚨We are officially changing the name 🚨

Have you heard of “lean mass hyper-responders” or LMHR… it may soon be called “Lean Mass Hyper-ABSORBERS”

Cc: @AdrianSotoMota @nicknorwitz @realDaveFeldman

🤯

Let me present some data from our clinic that we shared at @TheSMHP - that you may find interesting

🧵

Several weeks ago I put a poll asking people to guess what caused this?

So let’s dig in and find out:

We presented this case series of ~10 patients

Roughly 10 patients presented to our clinic who had elevated cardiac risk

Many of whom had evidence of plaque on CCTA or CAC

These patients wanted to hedge their bets but didn’t tolerate or didn’t want statin treatment

Some of them tried carbohydrate reintroduction or fiber supplementation with no improvement in lipids

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